Eyelid abscess as an initial manifestation of whipple’s disease: a case report and comprehensive literature review

Abstract Background Whipple’s disease, caused by Tropheryma whipplei, is a rare chronic infection predominantly affecting the gastrointestinal tract. Ocular involvement is uncommon, and periorbital manifestations are exceedingly rare. This case report highlights a unique presentation of Whipple’s di...

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Main Authors: Ashwaq Yahya Asiri, Khawlah A. Alzaben, Yousef A. AlOtaibi, Humoud Mohammad AlOtaibi, Hind Manaa Alkatan
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-03902-6
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Summary:Abstract Background Whipple’s disease, caused by Tropheryma whipplei, is a rare chronic infection predominantly affecting the gastrointestinal tract. Ocular involvement is uncommon, and periorbital manifestations are exceedingly rare. This case report highlights a unique presentation of Whipple’s disease as an eyelid abscess in a patient with type 1 diabetes mellitus. Case presentation A 38-year-old male with poorly controlled type 1 diabetes mellitus presented with a two-weeks history of progressive swelling in the left upper eyelid. The swelling initially appeared three months prior and was associated with mild pain. Clinical examination revealed a large, erythematous, bluish, and non-tender swelling in the left upper eyelid, causing mechanical ptosis. Additional lesions were noted on the scalp and abdomen. Imaging showed a well-circumscribed fluid-filled lesion in the left upper eyelid. A tissue sample was taken for culture and biopsy during surgical drainage. The histopathology showed foamy macrophages with Diastase-resistant intracytoplasmic organisms that were further demonstrated by Gram stain confirming the diagnosis of Whipple’s disease. Conclusion This case illustrates a rare presentation of Whipple’s disease manifesting as an eyelid abscess in a diabetic patient. The diagnosis was confirmed through histopathological examination, emphasizing the importance of considering Whipple’s disease in the differential diagnosis of atypical ocular presentations.
ISSN:1471-2415